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Researchers Call for Carb Restriction to be the Primary Diabetes Management Method — Instead of Low Fat

One of the most controversial topics within the diabetes community is diet and carbohydrate management. There has been a lot of infighting through the years over whether or not a high carbohydrate/low fat diet is the best, versus a high protein/low carbohydrate diet — as well as what defines a low carbohydrate diet. This has lead to a lot of frustration between patients, advocacy organizations, and nutrition professionals. On the one hand, a patient knows what the glucose meter says – eating a lot of carbohydrates (whole grain or not) leads to high blood glucose, but nutrition professionals and advocacy agencies tend to stick to low fat, instead. Advocacy agencies have long argued that they simply haven’t had the ‘science’ behind making further changes in recommendations, as well as a well defined guideline for what is ‘low carbohydrate.’

Now – more than 30 years after the initial guidelines of low fat recommendations, a large multinational team of researchers has published different recommendations in the Nutrition Journal, as well as defined the scope of what constitutes a low carbohydrate diet. The paper puts forth 12 points of evidence, backed by clinical studies – studies which aimed to show the safety and effectiveness of a low fat diet in improving heart health, but have universally failed to do so (as well as help ease the obesity epidemic). This has been likely because of the use of total and LDL cholesterol as markers of heart health, when the researchers argue — other markers have been consistently shown to be stronger: such as the ratio of total cholesterol over HDL and the ratio of triglycerides over HDL, both of which are easy to measure clinically.

The 12 points (which are explored in detail in the paper)

  1. High blood glucose is the chief concern of diabetes control.
  2. Increases in carbohydrate intake have driven the obesity and type 2 epidemics.
  3. Weight loss is not required in order to see benefits from restricting carbohydrate intake.
  4. No dietary intervention is better for weight loss than restricting carbohydrates.
  5. A low carbohydrate diet for people with type 2 diabetes is just as good as any other dietary intervention, and is often significantly better.
  6. Replacing carbohydrates with protein is generally beneficial.
  7. Dietary total and saturated fat do not correlate with risk of cardiovascular disease.
  8. Triglycerides levels are controlled by carbohydrate intake more than lipids (LDL, HDL).
  9. Glycemic control, or a well controlled HbA1c, is the best predictor of microvascular and macro-vascular complications.
  10. Restricting carbohydrates is the most effective method of reducing triglyceride levels and increasing good cholesterol (HDL) levels.
  11. People with type 2 diabetes on low carbohydrate diets reduce and frequently eliminate medications, while persons with type 1 diabetes lower their insulin needs.
  12. Intensive glucose management by restricting carbohydrates has no comparable side effects to doing so by using intensive pharmacologic treatment.

The researchers called upon government and health agencies to hold open hearings for review and vigorous scrutiny of the data and the process. It will be interesting to see how mainstream scientists, guideline agencies, and others react to this paper and if they embrace a dialogue. Some of the contributing authors have conflicts of interest, such as working (or having worked) for diet industries such as Jenny Craig industries or Atkins; or have their own profitable income from books on low carbohydrate methods, such as Dr. Richard K. Bernstein.

As always, approaches to managing our diabetes need to be supervised by our medical team – who is aware of our overall health and dietary needs and concerns. Do not embrace any new changes without consulting your medical team.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.